Description
SHIFT: Day Job
SCHEDULE: Full-time
Be part of an extraordinary team:
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action, and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
Network Data Specialist I, II, Sr Locations: GA, FL, NC, SC, PA, RI, MA, NY, NJ, NH (Fully Remote)
Build the Possibilities. Make an extraordinary impact:
The Network Data Specialist I is responsible for accurate and timely maintenance of provider information on claims and provider databases.
How you will make an Impact:
- Assists in synchronization of data among multiple claims systems and application of business rules as they apply to each database. - Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
The Network Data Specialist II is responsible for accurate, timely maintenance of critical provider information on all claims and provider databases.
How you will make an Impact:
- Maintains critical provider information on all claims and provider databases. - Synchronizes data among multiple claims systems and application of business rules as they apply to each database. - Validates the data to be housed on provider databases and ensuring adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing.
The Network Data Specialist Sr is responsible for accurate, timely maintenance of complex provider information and synchronization of data on all claims and provider databases including expertise on business requirements for multiple business regions.
How you will make an Impact:
- Leads the department in problem identification, analysis, and resolution for multiple system provider database issues. - Participates in system testing and analysis in support of new functionality, new system processes, and business rules changes. - Validates the data to be housed on provider databases and ensure adherence to business and system requirements of customers as it pertains to contracting, network management and credentialing. - Researches and resolves complex exceptions and error reports, determine regional/cap/business indicators for multiple business areas to assure accurate reimbursement based on provider contract and area fee schedules. - Determines training needs and train less experienced associates and outside customers on multiple provider data base systems and business requirements. - Audits for functional and business applications, and report accuracy standards.
Qualifications
Minimum Requirements: Requires a H.S. diploma; basic PC office software; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications: 1-3 years' experience in claims processing, provider, or credentialing strongly preferred.
Minimum Requirements: (Network Data Specialist II) Requires a H.S. diploma and a minimum of 3 years related experience; or any combination of education and experience, which would provide an equivalent background.
Minimum Requirements: (Network Data Specialist Sr) Requires a H.S. diploma and a minimum of 3 years Provider Database Rep experience; or any combination of education and experience, which would provide an equivalent background.
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few. The health of our associates and communities is a top priority for Anthem. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide - and Anthem approves - a valid religious or medical explanation as to why you are not able to get vaccinated that Anthem is able to reasonably accommodate. Anthem will also follow all relevant federal, state and local laws. Anthem, Inc. has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World's Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.antheminc.com. Anthem is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.
Internal Description REQNUMBER: PS74048-Florida
